New to CPAP, my nose hurts!

exodar · Post by **exodar** » Wed Apr 27, 2005 1:03 pm

After feeling tired during the day for the past 2 years (maybe even longer), I finally listened to my wife and family and got the sleep study done. Thinking I didn't have a problem, I was suprised to find out I had Sleep Apnea.

During my sleep study I stopped breathing between 80-90 times per hour and was choking all night...this suprised the heck out of me since I never noticed it at all!

So given my circumstances, I know that it is important for me to use the CPAP, but after 2 days, the bridge of my nose is killing me! Since it seems to be standard protocol on these boards, here is my equipment and setting:

Fisher & Paykel HC221LE
Respironics ComfortGel Nasal Mask
Pressure Setting: 6

I tried several of the nasal masks that the technician brought to my home and this one was by far the softest and most comfortable. However, after 2 nights I have a red mark on the bridge of my nose at the top and it hurts to touch. This might be gross, but I noticed a few pimples forming where that soreness is and I wonder if that is where the pain is coming from. Regardless, it is still a problem.

I originally thought the mask was too tight, but if I loosen it up anymore it leaks like crazy. There is a molding process you can do with the Gel and I am going to try that tonight, but I have my doubts since the Gel is so soft and kind of molds to my face anyway.

So I am not sure if it is just not being used to having something on the top of my nose like that, or if the excess heat and moisture is causing insensitivity and possibly pimple problems resulting in pain. The only thing that IS clear to me, is that I don't know what I should do about it.... endure the pain (which is hard...I ripped the mask off last night), or buy a new mask.

Anyone else experienced this? Please help....

Howkoolguy · Post by **Howkoolguy** » Wed Apr 27, 2005 1:19 pm

I had this mask the first week that I used my CPAP but had to give it up because I breath through my mouth. I loved the mask though as it was really comfortable. The pain on your nose sounds like it does not fit right. You may want to try changing the angle from the forehead to the nose and then retighten the straps to get a better fit.

Howard

jdschooler · Post by **jdschooler** » Wed Apr 27, 2005 1:27 pm

Exodar,

The mask you are using is a very good mask as far as comfort goes...even though you don't think so right now. I use the same one as a matter of fact about half of the time. I have found that no matter how comfortable a mask is I can only use it for a week or two then have to switch to my other which is a ResMed Seift Nasal Pillows which I also like very well but have to switch again more so because I notice that I am not sleeping as well if I use one mask too long.

Back to the Comfort Gel....I found out too after a week or so that tighter is not better...I also found a feature on it that the DME didn't explain to me when they fitted me. There is a brace that rests on your forehead right? This brace is adjustable at the top of the mask and it adjusts the pressur it applies on the bridge of your nose with little adjust necessary on the headgear. I had too tweak this adjust a little to find a confortable fit and maintain a seal. The other possibility is that it is infact the wrong size for you...I use a small and I like to think I have average facial features. As far as the form fitting procedure you are talking about I haven;t heard about it and am always interested in ways to improve comfort. I have mine pretty well adjusted now and even forget I'm wearing it. Hopefully you can get there too.

I do suggest that you get the ResMed Swift Nasal Pillows system. If you are not familiar with them go to CPAP.com and browse the products to ResMed Nasal Masks to get a better look at it. It sits under your nose with two pillow like prongs that rest against the bottom of your nares. Your face and visual field is completely clear of obstructions. Great for getting rid of that mask infront of your eyes or maybe watching TV as you fall asleep. However I do find that my leak rate is higher on the machine but this doesn't affect my therapy...The machine just says I have a higher leak rate. This system also will cause minor discomfort and redness in you nares as your skin adjusts and becomes used to this....It only took about a week or so before I had no problems at all. I do suggest that you use AYR Nasal Saline Gel in your nares at night to prevent dryness and improve the seal though.

I have only been CPAPing for about 3 months and am very comfortable with it now so I know you can too....There are alot of options of masks and nasal pillows out there but unfortunately they cost a bit to find the ones that work best for you.

Stick with it...it's your life on the line...and it's definitely worth the effort when you start feeling great again.

Keep us posted and good luck.

exodar · Post by **exodar** » Wed Apr 27, 2005 1:35 pm

Thanks for the advice and encouragement. I am wondering if I am just feeling some normal discomfort because I am not used to wearing this on my face at night.

I will try the adjustment you mentioned again. I have messed with it a few times, but probably not to the extent I need to.

As for the molding procedure. It was in the manual for that mask. Involves soaking it in hot water or something like that. When I get home and look at it further, I will post my findings. If you need a scan of that instruction page, I would be willing to share.

exodar · Post by **exodar** » Wed Apr 27, 2005 1:40 pm

I found a link for the custom molding procedure:

http://www.respironics.com/download/dow ... 0OIS%2Epdf

NeurosurgeryNP · Post by **NeurosurgeryNP** » Wed Apr 27, 2005 1:48 pm

I suggest to you the ResMed Activa - it is a nasal mask that basically sits ridicously loose on your face, almost to the point of falling off, until you turn your blower on and then in "inflates" to form a great seal. It works very well and leaves minimal marks. I have had the same problem as I have a weird nose. I am new to cpap as well - only about 7 weeks on it. Jen

chrisp · Post by **chrisp** » Wed Apr 27, 2005 2:28 pm

If you can only afford 1 mask make it the resmed Activa. You wont be disappointed. Stay away from anything that has comfort in the name. Its a trick !

rested gal · Post by **rested gal** » Wed Apr 27, 2005 5:01 pm

Different masks suit different people. If I had to have only one mask and if it had to cover the nose, ResMed's Activa would be the one for me.

Nasal pillows type masks (Breeze, Aura, Swift) are my real favorites, but whenever I feel like wearing a nasal mask for a change occasionally, the Activa is what I switch to. I love the way it's so leakproof even with the straps floppy loose.

There · Post by **There** » Wed Apr 27, 2005 10:16 pm

I originally had a gel mask and am very glad I got rid of it. I found it more irritating and more likely to leave marks on my face as well - I have fairly sensitive skin. My current mask, with silicone flaps, is much more comfortable.

Suggestions, though? Be sure you wash it regularly - something may be on it that irritates your skin from the original packaging. And, if you're breaking out, each time you put it back on, you transfer the bacteria and irritants back to your skin that the mask picked up from the night before.

I've heard people suggest KY as a solution to irritation, but I found that just being a tiny bit more generous with the night-time facial lotion works well, too - helps the seal and keeps down on irritation and controls wrinkles, too

IWannaSleep · Post by **IWannaSleep** » Wed Apr 27, 2005 11:56 pm

The literature that came with my Swift mask said not to use any lotions or creams on your face when using it. In fact the strongly reccommend washing your face clean just before putting the mask on. The claim is the chemicals in lotions and such can cause the material to deteriorate rapidly.

Also for washing they say to only use mild detergent without any perfumes, antibacterial ingredients. I'd be careful with the lotions and cleansers and make sure and follow any manufactureres suggestions.

andrew · Post by **andrew** » Thu Apr 28, 2005 12:59 pm

My advice is to stick with using whatever interface you have, I use swift nasal pillows and the were killing me for about a week and a half, no matter what size I used or how much lube I used but now it's great and very comfortable, I think it just takes awhile for skin to adjust to something new like this, my pain was in my nares as well on the back of my head from the strap, but it has gone away thankfully, because I was getting the point where I couldn't take the pain so be tough a little while longer if you can and Im sure you will find relief

Tired-in-Tenn · Post by **Tired-in-Tenn** » Thu Apr 28, 2005 1:08 pm

When I first starting using my Mirage Activa mask I developed a sore on the bridge of my nose within 3 days of using it. It was an open sore and hurt like heck! I went to Walgreens and bought some MoleSkin in the foot care section and cut it into strips and applied it (with some triple antibiotic cream) to the sore spot on my nose. I slept with this on there for a couple of weeks until the sore healed and then quit using the MoleSkin. I then started loosening my mask straps to try to prevent this from reoccurring. I now sleep with my bottom straps so loose that there is slack in them. The mask seals well and I can even sleep on my side with it like this without leak problems.

(Not-so-)Tired-in-Tenn

WillSucceed · Post by **WillSucceed** » Thu Apr 28, 2005 2:07 pm

I find that I cannot tolerate masks that touch the bridge of my nose either. I have an Activa and think it is a great mask that seals well, I just can't stand the sore nose that I get from it and, every other mask that I have tried.

If you are going to use a mask that is NOT nasal pillows, make sure to clean and rinse the mask well, clean your face with an anti-bacterial soap and rinse really well, protect the sensitive nose-bridge with moleskin or, Extra-Thin Duo-Derm (you can get it at the DME). This stuff is expensive, but it helps alot.

I'd sell my Activa in a flash, not because it is not a good mask, but because I'm not right for it. The Activa seals really well and stays put with the straps kept very loose.

TXKajun · Post by **TXKajun** » Thu Apr 28, 2005 9:47 pm

I also had a bit of a problem with a sore nose bridge after a few nights of using my Ultra Mirage FF mask. I went to Walmart and got a roll of "paper tape"...right next to the adhesive tape...for about $2 and put a small strip over the bridge of my nose for about 5 nights. No problems since then.

And, in response to a couple of other posts, I LOVE my Ultra Mirage. It took a few nights to get it adjusted properly (looser, rather than tighter, forehead rests in a medium-high position) but now, I very seldom have problems. Once in a while, if my pressure gets up around 14 or 15 (I was titrated at 16), the mask leaks (sounds like face-farts). I usually wake up, roll over and am off again shortly. Once in a great while, I struggle with it overnight, but those are few and far between (well, as few and far between as you can get after 2.5 months on this thing).

This therapy WORKS! (But only if you USE it!!!)

snork1 · Post by **snork1** » Thu Apr 28, 2005 10:32 pm

Different masks work for different people, but the Comfort gel seems to have one of the worst batting averages out there. As one person put it "it ruined the term Comfort for me".

Tape over the contact point on your nose can help a bit. And some of the suggestions already mentioned such as the Activa or Swift have the odds much more in your favor for finding compatibility with YOU. (Wear the activa EXTREMELY loose)

The BEST approach, if you can swing it, is to rotate between (at least) two different interfaces that have different contact points. Many of the more experienced (and compliant) CPAPers seem to use this method. I rotate between the activa and the Swift, for the moment anyway. This gives a chance to toughen up instead of just developing a sore.

but of course, Your mileage may vary......

New to CPAP, my nose hurts!

New to CPAP, my nose hurts!

Comfortgel Nasal Mask

Sore nose

Uncomfortable Gel